Components of Health, Part II

Part 1: …To build a healthier society, you need to recognize the importance of much more than medical definitions of physical and mental wellbeing. Prescribing vegetables and exercise to an overweight person doesn’t usually result in weight loss — because humans are not machines with simple inputs and outputs. We’re complicated creatures who need the alignment of a wide range of incentives and opportunities in order to make healthy choices. I’m unpacking the idea of “health” a little further here…

First, I want to examine food. Only to a starving person would food be simply sustenance. To anyone else, it’s so much more. Food is memory. It’s religion. It’s family, emotion, gift, battle, grief, consolation, and identity. Failing to recognize the cultural and individual significance of food is like thinking of a person as a well-composed collection of molecules. As a society we need to examine why people eat the foods they do, and what it might take to shift those traditions or habits towards an emphasis on nourishment. What barriers to access do individuals or communities face? What systems are causing hunger, malnutrition, and obesity? How do we replace those systems with ones that make it easy for everyone to eat in ways that sustain the body as well as the soul? The answers are more involved than a doctor might assume at first glance.

After food, consider environment. A patient’s built environment, the spaces that have been constructed around her, determine whether or not she exercises. Does she live at the end of a cul-de-sac and therefore must drive everywhere she goes? Does she have enough streetlights to make her children safe on the sidewalk at night? Does she live near a park where she can run or bike without being afraid of getting hit by a car? Can she afford a gym membership? Does she have time for exercise between her two jobs? Does she live in a community designed to facilitate human encounters and connection — or is she isolated in her lonely life? Are there environmental pollutants impacting her health, like exhaust from a nearby power plant that causes her respiratory problems? If your environment is holding you back, you can’t achieve health no matter how much you might try.

In addition to food and environment, I believe firmly that mental and physical health cannot be achieved without the right systems of education. Individuals need to understand the exact steps to take to maximize their own health. Everyone wants to be healthy, but even when the right opportunities are there, not everyone knows how to make the right choices. I once spent a summer leading nutrition tours in grocery stores in low-income neighborhoods of NYC. I was inspired by the determination I saw displayed by the adults on my tours. They listened to their doctors. They knew that too much salt, for example, made their high blood pressure worse. But no one had ever taught them how to read a nutrition label. Some didn’t know that “sodium” meant “salt.” No one had showed them that nutrition labels measure the salt quantities in just one serving rather than the entire package. My tour participants were horrified to learn these things. They had been doing their best to make healthy decisions, using the knowledge they had, but their knowledge was incomplete. Many different kinds of education on many different levels is necessary for people to have the tools they need to make the healthy decisions they want.

As I conclude my summer contract with Health:Further, I feel encouraged. I feel excited about the energy around improving our health system, about the ideas buzzing and the connections being made through the work of this mission-driven company. But all too often those conversations are dominated by the conventional healthcare system in place in this country. Sometimes the conversation expands to include alternatives to that hospital system, like new businesses that want to replace parts of it. As I leave this company, I encourage Health:Further and its employees not to forget that crucial distinction made at the beginning: There’s so much more to health than healthcare.